COVID-19 convalescent plasma as long-term therapy in immunodeficient patients?
Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine. 2021
OBJECTIVES The patients with hematological malignancies are a vulnerable group to COVID-19, due to the immunodeficiency resulting from the underlying disease and oncological treatment that significantly impair cellular and humoral immunity. Here we report on a beneficial impact of a passive immunotherapy with convalescent plasma to treat a prolonged, active COVID-19 infection in a patient with a history of nasopharyngeal diffuse large B-cell lymphoma treated with the therapy inducing substantial impairment of particularly humoral arm of immune system. The specific aim was to quantify SARS-CoV2 neutralizing antibodies in a patient plasma during the course of therapy. MATERIALS AND METHODS Besides the standard of care treatment and monitoring, neutralizing antibody titers in patient's serum samples, calibrated according to the First WHO International Standard for anti-SARS-CoV-2 immunoglobulin (human), were quantified in a time-dependent manner. During the immunotherapy period peripheral blood flow cytometry immunophenotyping was conducted to characterize lymphocyte subpopulations. RESULTS The waves of clinical improvements and worsening coincided with transfused neutralizing antibodies rises and drops in the patient's systemic circulation, proving their contribution in controlling the disease progress. Besides the patient's lack of own humoral immune system, immunophenotyping analysis revealed also the reduced level of helper T-lymphocytes and immune exhaustion of monocytes. CONCLUSION Therapeutic approach based on convalescent plasma transfusion transformed a prolonged, active COVID-19 infection into a manageable chronic disease.
Potential benefit of convalescent plasma transfusions in immunocompromised patients with COVID-19
The Lancet. Microbe. 2021;2(4):e138
Convalescent plasma as potential treatment for covid-19 patients
Revista Cubana De Investigaciones Biomedicas. 2021;40(1):1-19
Introduction: Convalescent plasma is a form of passive immunotherapy which has been used for the treatment and prevention of many infectious diseases for more than one century Given the absence of a specific treatment for the novel coronavirus SARS-CoV-2, convalescent plasma is a potential therapeutic alternative against COVID-19 Objective: Carry out a review about the use of convalescent plasma as a therapeutic alternative against COVID-19 Discussion: A search was conducted about the topic in the databases Pubmed, SciELO, Lilacs, Cochrane Library and Web of Science Convalescent plasma has been shown to be effective in the treatment of several viral diseases However, evidence of its use in COVID-19 patients is scant Promising results have been obtained, though, but they are not conclusive due to the need of a larger number of clinical trials In Cuba this treatment is included among the clinical management protocols for COVID-19 Conclusions: This alternative is an immunotherapeutic tool for the treatment of COVID-19 patients, since it improves their clinical status and reduces lethality rates However, more controlled and randomized clinical trials are required confirming its effectiveness and safety © 2021, Editorial Ciencias Medicas All rights reserved
High-titre anti-SARS-CoV-2 convalescent plasma donation after donors' vaccination
Vox Sanguinis. 2021
Plasma exchange followed by convalescent plasma transfusion in COVID-19 patients
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2021;:103141
BACKGROUND Coronavirus disease 2019 (COVID-19) is an emerged pandemic disease with no specific treatment. One of the potential treatments in newly found infectious disease is plasma exchange (PE) with convalescent plasma transfusion (CPT). This case series aimed to evaluate the primary PE and CPT in five Iranian COVID-19 patients. METHODS Five patients with confirmed COVID-19 who had acute respiratory distress syndrome and were supported by mechanical ventilation were treated with two consecutive PE containing fresh frozen plasma (FFP) of healthy donors and 0.9 % saline solution containing 5 % human albumin. Thereafter, CPT was performed just like PE, except that the FFP in this step was substituted with convalescent ABO-matched plasma. Clinical and laboratory factors were evaluated before and after treatments. RESULTS Three to Four patients showed lower body temperature and improved oxygen saturation as well as reduced laboratory factors such as c-reactive protein, lactate dehydrogenase, creatine phosphokinase (total and myocardial isoform), aspartate aminotransferase, blood urea nitrogen, bilirubin (total and direct), D-dimer, interleukin-6, and CD4+/CD8 + T cells ratio initially after PE and continued to improve so that they were discharged. One patient due to secondary hemophagocytic lymphohistiocytosis and extensive lung fungal infection was expired. DISCUSSION Overall, the PE followed by CPT was beneficial in reducing acute inflammation led to a considerable improvement in patients' clinical features. It seems that PE along with CPT could provide clearance of pro-inflammatory mediators as well as the positive effects of CPT. Controlled studies are required to confirm the effect of PE/CPT compared with other therapeutic approaches.
Rapid Clinical and Radiological Improvement in a Patient with Severe COVID-19 Infection Treated with Convalescent Plasma
The COVID-19 pandemic has affected more than 100 million people worldwide One of the major presentations is pneumonia Patients are classified as severe when they have an arterial oxygen saturation of less than 94% on breathing room air We present a case of a healthy 29-year-old man who had severe COVID-19 pneumonia and responded dramatically to two doses of convalescent plasma This case underlines the importance of administering the plasma in the first few days of the disease
Convalescent Plasma Therapy in the management of COVID-19 Patients- The newer dimensions
Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine. 2021
BACKGROUND COVID 19 infection caused by novel coronavirus with no specific established treatment. Convalescent Plasma Therapy has been authorized as an off-label therapeutic procedure. We assessed the outcome of convalescent plasma (CP) units versus standard treatment on the complete recovery, improvement and 28 days' mortality of COVID 19 patients. MATERIALS AND METHODS The present was multi-centric case controlled observational prospective study. The study was conducted for a period of four and half months from July 15 2020 to 30 November 2020 after taking approval from the Expert Committee, Health & Family Welfare Department, Government of Odisha. Plasma therapy was applied on two groups of 1189 serious COVID patients (959 number of pre- critical and 230 number of critical patients) not responding to oxygen therapy. It was compared with non- transfused control group of 1243 patients (996 number of pre-critical and 247 number of critical patients). RESULTS Discharge was better in (55.5%) transfused than (43%)in non-transfused pre-critical patients and the mortality was lower (44.3%) in transfused, (48.9%) than non-transfused critical patients respectively. Complete recovery was highest in those who were transfused with CP with neutralizing titer more than 1:160(52.5%), 18-30 years' age group (64%), females (53%), ' O' Rh D positive blood group (51.5%). There was no adverse reaction due to CP transfusion. CONCLUSIONS CP is effective in improving the recovery rate with earlier discharge and decrease in the 28 days' mortality than in the control non-transfused group. CP with neutralizing antibody titer more than 1: 160 has the best outcome with complete recovery and decrease in the mortality. It is more effective in treating pre-critical patients when transfused early, in female patients, in younger age group and in blood group ' O' Rh D positive.
Neutralization of SARS-CoV-2 with IgG from COVID-19-convalescent plasma
Scientific Reports. 2021;11(1):5563
While there are various attempts to administer COVID-19-convalescent plasmas to SARS-CoV-2-infected patients, neither appropriate approach nor clinical utility has been established. We examined the presence and temporal changes of the neutralizing activity of IgG fractions from 43 COVID-19-convalescent plasmas using cell-based assays with multiple endpoints. IgG fractions from 27 cases (62.8%) had significant neutralizing activity and moderately to potently inhibited SARS-CoV-2 infection in cell-based assays; however, no detectable neutralizing activity was found in 16 cases (37.2%). Approximately half of the patients (~ 41%), who had significant neutralizing activity, lost the neutralization activity within ~ 1 month. Despite the rapid decline of neutralizing activity in plasmas, good amounts of SARS-CoV-2-S1-binding antibodies were persistently seen. The longer exposure of COVID-19 patients to greater amounts of SARS-CoV-2 elicits potent immune response to SARS-CoV-2, producing greater neutralization activity and SARS-CoV-2-S1-binding antibody amounts. The dilution of highly-neutralizing plasmas with poorly-neutralizing plasmas relatively readily reduced neutralizing activity. The presence of good amounts of SARS-CoV-2-S1-binding antibodies does not serve as a surrogate ensuring the presence of good neutralizing activity. In selecting good COVID-19-convalescent plasmas, quantification of neutralizing activity in each plasma sample before collection and use is required.
Plasma therapy in COVID-19: All that glitters is not gold
Lung India : Official Organ of Indian Chest Society. 2021;38(3):297-299
Constraints And Challenges In Convalescent Plasma Collection Amidst The Covid 19 Pandemic- Strategies And Recommendations To Overcome These
Transfusion Clinique Et Biologique : Journal De La Societe Francaise De Transfusion Sanguine. 2021
BACKGROUND COVID 19 is an acute respiratory disease caused by infection by the virus SARS-COV-2 and has been declared as a pandemic whose specific treatment is still not established. One of the options in the treatment is Convalescent plasma (CP) therapy when there is presence of required amount of neutralizing antibodies in the plasma of recovered COVID patients. Our objective was to analyze the challenges and the constraints encountered in motivation of COVID 19 recovered persons to come for the screening procedures and to convince the selected persons to come for Plasma donation voluntarily. MATERIAL & METHODS The present retrospective observational study was conducted for a period of five and half months. Out of 1515 number of persons contacted telephonically for Plasma donation, 1291 persons came for screening of whom 1028 persons were eligible for donation, 263 cases were deferred and 966 persons finally donated. RESULTS Maximum number of acceptance cases were from males-(98.7%). Of the accepted cases, (41.73%) were from the 18-30 years' age group. 33.94% were from blood group 'O' Rh D positive giving maximum contribution from any blood group. 38.3% of the accepted cases had resolution of all COVID symptoms within time period of 28-40 days. Maximum number of accepted individuals (39.75%) had suffered from multiple symptoms followed by 39.02% of asymptomatic persons. Highest number of Plasma donation was contributed by Odisha Government Police personnel (51.56%). DISCUSSION In this global ongoing pandemic, the "Fear Factor of contracting the disease" has acted as a major challenge in motivating and convincing a COVID recovered patient for plasma donation. The challenge before the medical professionals was to motivate, educate and convince the potential donors and the society about the likely benefits of convalescent plasma. This could be finally overcome with the help of positive orientation through social and conventional media as well as mass appeal from government side on the benefits of plasma therapy in saving lives in the present pandemic.